Why test

This page provides basic background information about HIV and hepatitis B and C, the benefits of testing and details about where one can access an HIV and/or hepatitis test. We have also included details of where you can access more information.

HIV – The Basics

HIV stands for human immunodeficiency virus. The virus attacks the immune system (CD4 cells) and in most cases weakens your ability to fight infections and other diseases like cancer

Therefore, a person with HIV is at risk of developing serious infections, which a healthy immune system would normally fight off

When a person with HIV develops certain illnesses and cancers, they are said to have developed acquired immunodeficiency syndrome (AIDS)

AIDS is the late stage of HIV infection, when, without treatment, your body has difficulty fighting life-threatening infections

There is no cure for HIV, but there are treatments to enable those with HIV a normal life expectancy

HIV is transmitted through contact with blood, genital fluids and breast milk

The main routes of transmission are through unprotected sex and by sharing injecting equipment

Hepatitis – The Basics

Viral hepatitis is inflammation of the liver caused by a virus. There are five different hepatitis viruses, hepatitis A, B, C, D and E. In particular, hepatitis B and C can lead to life threatening complications such as cirrhosis (liver scarring), liver failure and liver cancer

Hepatitis B and C are common among people at risk of, and among those living with HIV, because these viruses are transmitted in many of the same ways HIV is transmitted—through injection drug use and condomless sex. 50-90% of people who inject drugs and are HIV positive also have hepatitis C

Hepatitis B and C can be spread through contact with blood, bodily fluids, saliva, semen and vaginal fluid. Hepatitis C is primarily spread through contact with blood, but can sometimes be transmitted sexually and from mother-to-child during pregnancy. Sexual transmission is in particular seen among HIV infected men who have sex with men

It is important for people living with hepatitis B and C not to share needles (including tattooing equipment), razors or toothbrushes, in order to prevent transmission on to other people. It is also important for people living with hepatitis to use condoms during sex

Approximately 10% of adults with hepatitis B and 75% of those with hepatitis C do not clear the virus naturally and develop chronic hepatitis

Treatment advances mean that those living with hepatitis C can be cured. Hepatitis B cannot be cured, but effective treatment can permanently suppress the virus and thereby reduce the risk of liver damage

The benefits of early HIV and/or hepatitis diagnosis

For most people, being diagnosed with HIV and/or hepatitis is a life-changing experience and it is likely to have both emotional and practical implications. When an individual learns that they are living with HIV and/or hepatitis, they are in the best position to look after their health, including accessing timely HIV/hepatitis treatment and care.

A major international randomised clinical trial – The Strategic Timing of AntiRetroviral Treatment (START) study - has recently found that people living with HIV have a considerably lower risk of developing AIDS or other serious illnesses if they start taking antiretroviral treatment (ART) sooner, instead of waiting until their CD4 cell count drops below 350 cells/mm3.

These findings provide support for starting treatment immediately after diagnosis, and with the treatments available today and initiation of early treatment, someone with HIV can expect a normal life expectancy.

People with hepatitis C may be cured of the virus altogether. Treatment also reduces the likelihood of onward transmission to others.

Populations at higher risk of HIV and hepatitis

HIV: at risk groups

Populations at higher risk of HIV in Europe vary from country to country, but in general they include:

Men who have sex with men

People who inject drugs

Sex workers

Migrants (including persons originating from a high prevalence country) and mobile populations

Prisoners

Transgender

Hepatitis: at risk groups

Populations at higher risk of hepatitis are the same as those for HIV, above. In addition, those at increased risk of living with undiagnosed hepatitis include:

People on long-term haemodialysis

People who have received blood, blood products or organs before screening for hepatitis C was implemented, or where screening is not yet widespread

Healthcare workers

About HIV tests

The HIV tests used today can usually tell if a person has HIV within a month of their infection. In the past, an individual might have had to wait three months to be certain that their test result was accurate

The most common form of HIV test is a blood test – a small amount of blood is taken and examined

In some areas, saliva tests are available. In this test, a sample of saliva is taken using a mouth swab. In others, dried blood spot tests are available, in which the finger or heel is pricked and a spot of blood is blotted onto filter paper

Before someone is given a positive result the blood is tested several times using multiple robust methods in order to secure a result

The sooner people get tested, the sooner they can start life-saving treatment and diminish the risk of transmitting the virus to someone else

Delaying testing and access to treatment will allow the virus to spread in the body and damage health

HIV tests should be voluntary and offered in an appropriate setting, protecting the individual’s rights to privacy and confidentiality

About Hepatitis tests

The initial test for hepatitis is an antibody test, usually carried out using a blood sample, although oral swab kits are also now available. Hepatitis B and C can usually be detected in the blood 2-3 months after exposure, although this varies. The sooner people get tested, the sooner they can start life-saving treatment and diminish the risk of transmitting the virus to someone else

Delaying testing and access to treatment will allow the virus to cause further damage to the liver, which may lead to extensive liver disease and in some cases, liver cancer. Hepatitis tests should be voluntary and offered in an appropriate setting, protecting the individual’s rights to privacy and confidentiality

Where to get tested

Access to HIV and/ or hepatitis testing varies from country to country, however HIV and/ or hepatitis tests are often offered by the following:

Clinics or testing sites run by community based HIV/hepatitis organisations or charities

Some General Practitioner (GP) surgeries and GPs

Some contraception and young people’s clinics

Local drugs agencies

Antenatal clinics, if you are pregnant

Private clinics

To find an HIV and/or hepatitis testing centre near you, visit the NAM European test finder:

When and how to offer an HIV and/or hepatitis test – information for healthcare professionals

HIV and hepatitis testing should be voluntary, confidential and offered in a wider range of settings than is presently available. Other settings may include healthcare and community-based settings and via outreach programmes by peers and/ or medical staff

Help ensure you and your teams can effectively assess individuals for HIV and hepatitis testing by offering training on the risk-factors

A positive HIV or hepatitis test result requires that your patient is linked to appropriate care and treatment

Research shows that 95% of people will accept an HIV test when offered by their healthcare professional, so there’s no need to be ambivalent about talking about HIV and offering an HIV test in the same way you would offer other routine tests

For further information about when to offer HIV/hepatitis testing, testing diagnostics, etc. Please refer to international and European guidelines, including:

International Committee on the Rights of Sex Workers in Europe Statement on Mandatory and Forced Testing

Mandatory and forced testing for HIV and other STIs is not only a clear violation of sex workers’ human rights, including their right to privacy, dignity, bodily integrity, autonomy, and non-discrimination, but also a repressive and degrading form of exercising control over sex workers and their health. Coercive testing practices severely stigmatise sex workers as ‘vectors of disease’, thus framing them as entirely accountable for the spread of HIV and other STIs, and put sex workers at greater risk of violence, from police, clients, managers, families and co-workers. Read the full ICRSE statement here.

I’ve been diagnosed with HIV and/or hepatitis – what do I do?

If you’ve just been diagnosed with HIV and/or hepatitis, many questions and emotions may arise. But you are not alone, community and patient organisations across the world offer support to people who are living with HIV/hepatitis.

Some websites directly link people who have tested positive for HIV and/or hepatitis to appropriate care. If you haven’t already been referred for follow-up, it is important for your health that you seek treatment and care. Visit the following websites for further information and support:

Sponsorship statement: The EuroTEST initiative is governed by an independent steering committee. The Coordinating Centre is at CHIP, RegionH, Copenhagen, and the political secretariat at the EATG. The conditions of funding the initiative are approved by the Steering Committee. Industry sponsors are invited to quarterly updates but do not participate in the Steering Committee.

Financial support of the EuroTEST initiative provided by: Abbott, Boehringer Ingelheim, Bristol-Myers Squibb, Danish National Research Foundation (grant 126), European Commission under the 3rd and 2nd Health Programmes, European Centre for Disease Prevention and Control (ECDC), Gilead Sciences, GlaxoSmithKline, Merck, Pfizer, Schering-Plough, Swedish Research Council, ViiV Healthcare and Tibotec.

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